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Glutamine-enriched parenteral nutrition during postoperative catabolic state

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Previous clinical studies led to the hypothesis that glutamine-enriched total parenteral nutrition (TPN) has beneficial effects on clinical course and on changes in the immune system of patients in postoperative catabolic state.

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20 patients with esophageal carcinoma were enrolled in a controlled, prospective, randomized and double-blinded study after esophageal resection: 10 patients received glycyl glutamine-enriched (0.15 g glutamine/kg/d) TPN (Glamin®, Baxter Inc.) from day 2 postoperatively, 10 patients served as control (TPN without glycyl-glutamine: Vamin®, Fresenius Inc). Clinical scores and immunological parameters were observed before and during the first 8 days after surgery. Lymphocyte subpopulations were measured using flow cytometry analyses (FACS-Flow®, Becton Dickinson), plasma cytokine levels were determined using standard ELISA technique.


No significant differences were found, neither in clinical nor in immunological parameters: SAPS II scores as well as GORIS scores showed similar courses in both groups and ICU-days did not differ. Postoperative alterations of the immune system, measured by plasma IL-6 and procalcitonin levels as well as changes in lymphocyte counts and T4-T8-ratio, were nearly similar.


A beneficial effect of glutamine-enriched TPN could not be found in our study population. Further investigations are necessary to find out if higher doses and/or other patient groups are able to demonstrate similar effects as shown in former studies.


Supported by Baxter Inc., Munich, Germany.

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Ahlers, O., Harndt, K., Hodek, R. et al. Glutamine-enriched parenteral nutrition during postoperative catabolic state. Crit Care 4 (Suppl 1), P168 (2000).

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